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HEALTH DEPARTMENT 333 E. Washington St., Suite 1100
PO Box 2003 West Bend, WI 53095
Phone: 262-335-4462 Fax: 262-335-4463
2003 Annual Report by Linda Walter, Director/Health Officer www.co.washington.wi.us/chn
The mission of the Health Department is to Promote Health, Prevent Disease, and Protect the Public
Health Department Programs and Services by Major Focus Area for 2003 as outlined by Wisconsin Statute 251,
Administrative Rule HFS 140 and the 2000-2005 Health Department Strategic Plan Communicable Disease Control and Surveillance Disease & Injury Prevention Communicable Disease (CD) follow-up including new, Wisconsin Well Woman Program emerging & re-emerging diseases (i.e. Monkeypox & Pertussis) Tobacco Control services/coalition TB testing/case management Injury Control services/coalition Immunization programs/Annual Influenza program Disaster Preparedness Health Promotion Refugee communicable disease follow-up Women, Infant, Child (WIC) Program STD & Hepatitis counseling Committee & coalition participation HIV & AIDS partner notification program Information dissemination Environmental Health (Human Health Hazard Control) Public Health Nursing Radon information center/screenings Community Assessments Human health hazard & nuisance investigation including Maternal Child Health program/MCH lead risk assessments & screenings Prenatal Care Coordination/PNCC Rabies control coordination Other Public Health Services Beach water testing COP/ Protective services assessment Emergency Preparedness Hearing, Vision & Scoliosis screenings
Loan closet Washington County Board of Health Wis. ss. 251.03(1), 251.04(1)(2) & (5) -11 meetings held in 2003 Chairperson, Supervisor Donald Roskopf Members: Mary Callan, RN Supervisor Ralph Hensel Patricia Hrobsky, MPH, MSN Supervisor Delores Kruepke Doreen Weibel Dr. Steven Holcomb, MD, Medical Advisor The Wisconsin Department of Health and Family Services, Division of Public Health, formally reviewed the Washington County Health Department, on May 27, 1999. It was determined by a state team that the Health Department met the requirements of HFS 140.07(4) and the designation of Level II was granted on February 25, 2000. This Level II status can be in effect for up to 5 years and is based on a 3-step system. The Washington County Health Department has since maintained Level II designation contributing in part to the formulas utilized for state/federal consolidated grant funds each year.
Washington County
Performance Management Highlights Report
Health Department 2001-2003
Selected Health Department Services by focus area and how they are measured S1 Communicable Disease Control & Surveillance – number
reportable CD investigations with 100% follow up per state #4151 forms anticipated
State MCH program & County Lotus Notes & #4151 DPH forms
S2a Environmental Health –number radon kits distributed annually in Washington County
State MCH program & County Lotus Notes
S2b Environmental Health –number children receiving follow up annually with elevated lead levels
Stellar & HD system
S3a Health Promotion- WIC Program dollars spent in county annually from participants of any jurisdiction in WI
State Daisy System
S3b Health Promotion-Average monthly WIC caseload State Daisy System S4a Other public health (PH) services-Hearing Screenings
done annually in schools County/HD data base
S4b Other PH Services-Vision Screening done annually in schools
County/HD data base
Health Department Outcomes by focus areas and how they are measured O1 Communicable Disease-% caseload completing primary
immunizations by age 24 months Centers for Disease Control, CDC, standardized CASA tool
O2a Public Health Nursing-% MCH/PNCC caseload admitted early (first trimester of pregnancy) for adequate care
State MCH Data System Prenatal/Postpartum all programs report
O2b Public Health Nursing-% caseload with minimum birth weight of at least 2500gm
State MCH Data System Infant Report all programs
O3a Disease & Injury - % Wisconsin Well Women Program, WWWP, caseload in Division of Public Health, DPH, age defined high risk target group
WWWP data base and HD data base
O3b Disease & Injury - % Health Department caseload who smoke & report decreased tobacco usage during pregnancy
State MCH Data System Prenatal/Postpartum all program report
O4 Infrastructure/Performance Funding - % grant funds retained based on negotiated objectives fully met annually
State Grants and Contracts, GAC, system
**Communicable disease case investigations increased 89% from Y2002 to Y2003 and 151% from Y2001 to Y2003. Professional staff time spent on reportable disease investigations has increased 90% from Y2002 to Y2003 and 288% from Y2001 to Y2003 in part due to the 2003 Monkeypox and Pertussis or whooping cough outbreaks and necessary preparation for SARS, West Nile Virus, Smallpox and Chronic Wasting Disease in Y2002. New, emerging and re-emerging communicable diseases and the required surveillance and control are a local, state and national public health priority and identified in all three 5/10-year health plans
Washington County
Performance Management Highlights Report
Health Department 2001-2003
Table 1 Data on Selected Health Department Services 2001-2003 Selected Service
Target for 2001> 2001 2002 2003 2004 Status
S1- ** Reportable CD investigations
100% cases followed 280 372 704 Continue
S2a- Radon kits Increase awareness 373 312 445 Continue S2b-Lead levels 100% children
followed 32 28 20 Continue
S3a-WIC dollars Retain locally $556,406 $577,126 $642,906
Continue
S3b-WIC caseload
100% presenting 953 1001 1126 Continue
S4a-Hearing screening
100% presenting 2237 2355 2174 Continue
S4b-Vision screening
100% presenting 2209 2461 2362 Continue
Table 2 Data on Selective Health Department Outcomes 2001-2003 Outcome of services
Target for 2001> 2001 2002 2003 2004 Status
O1-immunizations
National goal 90%
77% 85% 87% Continue
O2a- first trimester of pregnancy
At least 50% MCH & PNCC caseloads
56% or 86
women
62% or 124 women
59% or 95
women
Continue
O2b- birth weight
At least 60% caseload born above 2500 gm
83% or 163 infants
73% or 116 infants
73% or 124 infants
Continue
O3a- WWWP
State DPH goal is 75% of caseload between 50-64 yr
55% or 54
women
58% or 44
women
62% or 57
women
Continue
O3b- decreased tobacco use
75% MCH & PNCC caseload reducing smoking
83% or 99
women
90% or 104 women
83% or 58
women
Continue
O4-grant funds retained
95% funds retained for # objectives negotiated
100% of 16
100% of 18
100% of 17
Continue
Health Department activities and services were prioritized during Y2003 resulting in less outreach for some services & programs, delayed data entry, less committee work with partners and decreased planning ability. Full staffing was not constant due to a variety of factors and increased the collective workload at the Health Department.
Communicable Disease Wis. Stat. 251.05(2) & 252 -HFS 140.04(b), 144 & 145 Strategic Plan Long Term Goal 1: The public’s health will be protected from preventable communicable diseases Desired outcome or target to be accomplished: Children will be protected from vaccine preventable communicable diseases 2003 Accomplishments: Media campaign including radio jingle, newspaper ads, payroll stuffers, school newsletter and insert
that went to 47,000 homes promoting childhood immunizations Collaboration with county District Attorney’s office and schools to decrease number of students not
complaint with Wisconsin Immunization Law Conducted 127 Monkeypox investigations = 375 hours of staff time Conducted 110 Pertussis or whooping cough investigations = 267 hours of staff time
Environmental Health Wis. Stat. 251.05(2) & 252 & HFS 140.04(1)(e) & (f) Strategic Plan Long Term Goal 2: Public is protected from unhealthy environmental conditions where they live, work and play Desired outcomes or target to be accomplished: Investigation of potential human health hazards and preparedness and planning for disasters regularly occurs 2003 Accomplishments
Participated with city of Hartford in human health hazards & lead investigations 117% increase in preparedness hours from 963 hours in Y2002 to 2,085 hours in Y2003
Disease and Injury Prevention Wis. Stat. 251.05(2)(a) & HFS 140.04(1)(c) Strategic Plan Long Term Goal 3: Health of public is protected and promoted through prevention information and activities Desired outcome or target to be accomplished: Focus on prevention of the leading causes of death by age group (heart disease, cancer, strokes & injuries)
2003 Accomplishments Partnered with the West Bend School and Kewaskum School Districts to identify 4 to 8 year olds
needing appropriate car seat restraint –distributed 203 booster seats at no charge Outreach for under-served and income/age eligible women in need of breast and cervical screenings
through the Wisconsin Well Women Program (WWWP) was conducted at the Synergy Women’s Health Fair in March and the Aurora Washington County Women’s Expo in October 80 medical doctors, dentists and chiropractic clinics partnered & publicly advocated in support of
smoke-free environments and acknowledged the dangers of secondhand smoke in a newspaper advertisement
Health Promotion Wis. Stat. 251.05(2)(a) & 253.06 & HFS 140.04(1)(c) Strategic Plan Long Term Goal 4: Public’s health protected and promoted through health promotional information and activities Desired outcome or target to be accomplished: Information is available to the public about factors known to affect health and well-being of all 2003 Accomplishments The Women, Infants and Children, WIC, program developed a new initiative that increased the
percentage of mothers breastfeeding for at least 2 weeks from 56% in 2002 to 71% in 2003 Participated in the annual spring Celebrate Families Event – attendance over 3500 Regularly updated the Health Department website with health information and resources
Generalized Public Health Nursing Services Wis. Stat. 251.04(8) & HFS 140.04(1)(a) Strategic Plan Long Term Goal 5: Public health needs will be balanced with community resources/capacity Desired outcome or target to be accomplished: Regular community assessment to identify risk populations & balance available resources 2003 Accomplishments Partnered with Aurora Health System in a local and regional health survey project Successful completion of parent education project piloted in 2002 Piloted new state data system, SPHERE, that was implemented January 2004
Welcome to the Public Agency Center
The Health Department is located on the 1st floor – Suite 1100The Health Department is located on the 1 floor Suite 1100
Our reception area has information on the services we offer in our departmentoffer in our department
WIC window across from 1113 A & B
H lth D t t 18 ¾ FTEHealth Department 18 ¾ FTEsDirector/Health Officer
1 FTE
Assistant Director1 FTE
Public Health Nursing Environmental Health Women Infants Children (WIC) Support
1 FTE
Public Health NursesBSN
6 FTEs, 3 - .75 FTEs, 1 .5 FTE
Environmental Health SpecialistRegistered Sanitarian
1 FTE
WIC Program Supervisor1 FTE
Admin SecretaryFinancial Clerk
1 FTE
Tobacco Control Specialist.75 FTE
WIC Health Screener1 5 FTE
WIC Dietetic Technician1 .5 FTE
Lead Public Health Tecnician1 75 FTE
Program Assistant/Receptionist2 - .5 FTEs
WIC Program Assistants1 FTE & 1 .5 FTE
1 .5 FTE
Public Health Technician1 FTE
1 - .75 FTE
5 Required Services5 Required Services of all LHDs
• Communicable disease surveillance, prevention & controlp
• Generalized Public Health Nursing• Health Promotion• Health Promotion• Disease Prevention• Human Health Hazard prevention &
control
Communicable Disease Prevention, Surveillance and Control A lot of activity behind the scenes
CD investigations & follow-upsTB testing/case managementImmunization Program & ClinicsImmunization Program & ClinicsRefugee CD follow-upsSTD & Hepatitis counselingHIV & AIDS t tifi tiHIV & AIDS partner notification Disaster Preparedness for CD
A nurse prepares dry ice for one of our clinics in the communityour clinics in the community
The vaccines and supplies are packed
for transport toto
Germantown and Hartford
The nurses fill the syringes in preparation forpreparation for
the clinic
Vaccine storage with back d lup power and alarm
Development of a data base to track Environmental Services and Communicable Disease was done inServices and Communicable Disease was done in
collaboration with the IS Department
O i d i i i ll b i i hOngoing preparedness training in collaboration with Emergency Management and the Washington County Health Care Partners assisted in the Monkeypox and ypPertussis outbreaks
Environmental Health (Human Health Hazard Control)Hazard Control)Radon information center & screenings
Human health hazards including lead risk assessments & screenings & nuisance investigations including collaboration with local jurisdictionsincluding collaboration with local jurisdictions
Rabies control coordination with law enforcement
B h t t ti i ll b ti ithBeach water testing in collaboration with Planning & Parks
Emergency Preparedness in cooperation withEmergency Preparedness in cooperation with Emergency Management, local Fire/EMS, Law Enforcement, & the WC Health Care Partners C iCommittee
Lead information was distributed to families atLead information was distributed to families at the Celebrate Families Day
The Environmental Health Specialist loans out the HEPA filter vacuum to citizens
Disease & Injury Prevention
Wisconsin Well Woman services/coalition
Tobacco Control services/coalition
Injury Control services/coalition
Wisconsin Well Woman Program community coalition “It’s A Stitch Quilt Guild” from Jackson donation forIt s A Stitch Quilt Guild from Jackson donation for state-wide WWWP Pin Fund.
Tobacco Control Specialist
Booster Seat event at the Public Agency Centeroos e Se eve e ub c ge cy Ce e
S i C f F ll P iSenior Conference – Falls Prevention
Celebrate Families car seat display
Celebrate Families Injury Prevention TeamInjury Prevention Team
West Bend Fire Department Station 2
Open House – car seat check
Hartford Fire Department
Open House car seat check
Walk Your Child To School Day held at McLane School in partnership with SafeKidsSchool in partnership with SafeKids
Health Promotion
Women, Infant, Child (WIC) Program
Committee & coalition participation
Information dissemination
Webpage Webpage
WIC StaffWIC Staff
Celebrate Families
Public Health Nursing
Community Assessments
Maternal Child Health program/MCH Maternal Child Health program/MCH
Prenatal Care Coordination/PNCC
Other Public Health ServicesOther Public Health Services COP/Protective services assessment
H i Vi i & S li i i Hearing, Vision & Scoliosis screenings
Loan closet
Our Video Tape Collection that can be checked out p
Map of Maternal Child locations (daycares, schools, after school programs etc ) in Countyschool programs, etc.) in County
Health Promotion teaching materials and gscreenings
A coalition has been formed to promote uniformA coalition has been formed to promote uniform standards for Blood pressure measurement
To Summarize
• 2003 was a busy year• Communicable Disease services expandedCommunicable Disease services expanded
significantly• Maternal Child caseload decreased slightly• Maternal Child caseload decreased slightly• Maternal Child services reached a higher %
f d i k liof targeted at risk clients• Preparedness hours increased significantly
WASHINGTON COUNTY HEALTH DEPARTMENTWASHINGTON COUNTY HEALTH DEPARTMENT COMMUNICABLE DISEASE PROGRAM
2001-2003
31313500
2500
3000
Investigations
1570
1945
1651
1500
2000Contacts
St ff H
280 372
704788 806
500
1000Staff Hours
02001 2002 2003
This chart reflects the significant increase in CD caseload.
Revise 02b with last row 2001 2002 2003
# annual WC births 1482 1515 1485# annual WC births 1482 1515 1485
# clients receiving MCH/PNCC
272 279 231
# MCH/PNCC visits annually
3006 3572 3029
% county births on 18% (272/1482) 18% (279/1515) 16% (231/1485)% yMCH/PNCC
% ( ) % ( ) % ( )
Average # visits per client on MCH/PNCC
11.1 visits/client(3006/272)
12.8 visits/client(3572/279)
12.6 visits/client(3029/231)( ) ( ) ( )
% clients on MCH/PNCC and WIC
61% 61% 65%
% low birth weight born (LBW) in county
5.8% (86/1482) 5.9% (90/1516) 4.5% (67/1485)
% LBW born with 12% (10/86) 11% (10/90) 70% (47/67)% LBW born with WCHD intervention
12% (10/86) 11% (10/90) 70% (47/67)
Preparedness – 117% increase
Y2002 963 hours(approximately .5 FTE)( pp y )
Y2003 2,085 hours(approximately 1 FTE)(approximately 1 FTE)
2003 Wisconsin Act 1862003 Wisconsin Act 186(formerly SB 120)
• Public Health Council- new 23 member advisory group on progress of 10-year health plan & coordination of responses to public health emergencies
• Reimbursement for local health departments for quarantine costs• Statewide intrastate mutual aid for emergency management programs,
emergency medical services programs, fire departments and local health departmentshealth departments
• Required utilization and training in Incident Command System (ICS) for all emergency response agencies, including local health departments depa e s
• Exemption from liability expanded to include persons providing equipments or services under the direction of DHFS or a local health department acting as agent of DHFS in a public health emergency
Mission Statement
• Preserve and Promote health for all
• Prevent disease, injury & premature death
• Protect the Public – ensuring conditions in which all can be safe & healthy
Public health departments are like the police and fire departments.
They teach and practice prevention, but y p p ,are prepared to act in emergencies.
And, while the public appreciates them most in emergencies the are tr lmost in emergencies, they are truly
successful – and least noticed – when their prevention efforts work.